PSEUDOANEURYSM OF THE ANTERIOR SUPERFICIAL TEMPORAL ARTERY

Pseudoaneurysm of the superficial temporal artery must be considered i n the differential diagnosis of masses of the lateral forehead and tem poral fossa. While the first reported case of a temporal artery aneury sm was reported by Thomas Bartholin in 1740, there is scant mention of this lesion in the plastic and maxillofacial surgical literature. Pse udoaneurysms can arise in the forehead and scalp as a result of blunt traumatic impingement of the superficial temporal artery against the c alvarium. The anterior branch of the artery is most vulnerable, becaus e in the lateral forehead it courses over the frontal osseous ridge in the galea aponeurotica formed by the fusion line of the deep and supe rficial temporalis muscle fascia. This dense fascial investment has a tethering effect in the gap between the temporalis and frontalis muscl es and prevents the artery from displacing laterally in response to tr aumatic forces, A history of recent blunt trauma or surgery to the for ehead, combined with a pulsatile bruit, should direct the physician to the diagnosis of pseudoaneurysm of the superficial temporal artery. T reatment is surgical resection of the involved segment without the nee d for reconstruction. This report includes a review of the literature and presents the first documented case of a bicycle helmet as the caus e of a superficial temporal artery pseudoaneurysm.